The New York Times highlights a provision of the stimulus bill that will provide funding for comparing the effectiveness of different medical treatments for the same health problem.

Under the legislation, researchers
will receive $1.1 billion to compare drugs, medical devices, surgery
and other ways of treating specific conditions. The bill creates a
council of up to 15 federal employees to coordinate the research and to
advise President Obama and Congress on how to spend the money.

The
program responds to a growing concern that doctors have little or no
solid evidence of the value of many treatments. Supporters of the
research hope it will eventually save money by discouraging the use of
costly, ineffective treatments.

The soaring cost of health care
is widely seen as a problem for the economy. Spending on health care
totaled $2.2 trillion, or 16 percent of the nation’s gross domestic
product, in 2007, and the Congressional Budget Office estimates that, without any changes in federal law, it will rise to 25 percent of the G.D.P. in 2025. . . .

As
Congress translated the idea into legislation, it became a lightning
rod for pharmaceutical and medical-device lobbyists, who fear the
findings will be used by insurers or the government to deny coverage
for more expensive treatments and, thus, to ration care. In
addition, Republican lawmakers and conservative commentators complained
that the legislation would allow the federal government to intrude in a
person’s health care by enforcing clinical guidelines and treatment
protocols.

The money will be immediately available to the Health and Human Services Department
but can be spent over several years. Some money will be used for
systematic reviews of published scientific studies, and some will be
used for clinical trials making head-to-head comparisons of different
treatments.

For many years, the government has regulated drugs
and devices and supported biomedical research, but the goal was usually
to establish if a particular treatment was safe and effective, not if
it was better than the alternatives. Consumer groups, labor
unions, large employers and pharmacy benefit managers supported the new
initiative, saying it would fill gaps in the evidence available to
doctors and patients.

“The new research will eventually save money and lives,” said Representative Pete Stark, Democrat of California. The
United States spends more than $2 trillion a year on health care, but
“we have little information about which treatments work best for which
patients,” said Mr. Stark, who is the chairman of the Ways and Means
Subcommittee on Health. In the absence of information on what
works, Mr. Stark said, patients are put at risk, and billions of
dollars are spent each year on ineffective or unnecessary treatments. . . .

Lawmakers
and lobbyists agree that researchers should compare the clinical merits
of different treatments. Whether they should also consider cost is
hotly debated. Representative Charles Boustany Jr., a Louisiana
Republican who is a heart surgeon, said he worried that “federal
bureaucrats will misuse this research to ration care, to deny
life-saving treatments to seniors and disabled people.” . . .

Congress
did not say exactly how the findings should be used. Private insurers
can use the data in deciding whether to cover new drugs and medical
procedures, but it is unclear how Medicare will use the information. Under
existing law, Medicare generally covers any treatment that is
“reasonable and necessary for the diagnosis or treatment of illness or
injury,” and the agency does not have clear legal authority to take
costs into account when deciding whether to cover a particular
treatment. . . .